Exploring Fractional Pigment Toning: A Novel Approach for Treating Benign Pigmented Lesions in Asian Patients With Fitzpatrick Skin Types III-V.

BACKGROUND/OBJECTIVE: Laser therapy has emerged as a widely favored treatment option for solar lentigines (SL). However, a significant challenge associated with this treatment, particularly among individuals with darker skin tones, is the notable risk of postinflammatory hyperpigmentation (PIH) induction. In response to these concerns, the authors conducted a prospective, self-controlled study to comprehensively evaluate the safety and effectiveness of 532-nm picosecond laser, both with and without a microlens array (MLA), for the management of SL in patients with Fitzpatrick skin types (FST) III-V. METHODS: Twenty-seven patients with FST III-V and bilateral SL on the face underwent randomized treatment. One side of the face was treated with a 532-nm picosecond laser coupled with an MLA, utilizing the fractional pigment toning (FPT) technique, while the other side received treatment without the MLA, following the conventional technique (CT). The FPT technique utilized a 9-mm spot size with a fluence of 0.47 J/cm2 for two passes covering 40% of the area. In contrast, the CT used a 4.5-mm handpiece with fluence ranging from 0.3 to 0.7 J/cm2. Patients received a single treatment and were evaluated for pigment clearance, occurrence of PIH, and other adverse effects at 2 weeks, 1, 3, and 6 months posttreatment. RESULTS: Twenty-seven participants completed the study protocol. Analysis of pigment clearance, measured via 3D photography, showed significant improvement from 2 weeks to 6 months posttreatment for both the FPT technique (p < 0.001) and CT (p = 0.004). PIH occurred in 64%, 80%, 96%, and 88% of cases on the CT side, compared to 8%, 32%, 36%, and 16% on the FPT technique side at 2 weeks, 1, 3, and 6 months posttreatment, respectively. The incidence of PIH was significantly lower on the FPT technique side compared to the CT side throughout the follow-up periods. Additionally, transient and mild hypopigmentation occurred in one participant (4%) on the FPT technique side and in five participants (20%) on the CT side. No other adverse effects were observed during the study. CONCLUSIONS: The 532-nm picosecond laser emerges as a safe and efficacious treatment modality for SL in individuals with FST III-V. Particularly noteworthy is the efficacy of the FPT technique, which demonstrates comparable effectiveness while significantly reducing the incidence of PIH compared to the CT.

Laser treatment of benign melanocytic lesion: a review.

Treatment of pigmented lesions is one of the major challenges of laser and cosmetic practitioners. The most common pigmented lesions that are treated by lasers are melanocytic nevi, ephelides, solar lentigines, and café au lait macules. Melanin absorbs different wavelengths (500-1100 nm); thereby, treatment of various pigmented lesions requires the application of lasers with different wavelengths. Choosing the most appropriate type of laser depends on various factors such as the chromophore and the location of a specific lesion in the skin. In this paper, we aim to review the most efficient laser treatment protocols for each pigmented skin lesion and compare their efficacy in each part based on the previous studies.

Treatment of benign hyperpigmentations and pigmented scars by 755 alexandrite laser comparing the Single Pass versus MultiPass (MoveoPL) emission in skin types I-IV.

Lasers are effective treatments for benign hyperpigmentations but may be difficult especially in darker skin type. In this randomized split-face controlled study on benign hyperpigmentations and pigmented scars, we compare the standard Single Pass (SP) emission with the MultiPass emission (MoveoPL) 755 alexandrite laser. Patients, skin types I-IV, with solar lentigines and ephelides of the face, chest, and hands and patients with pigmented scars of the legs, underwent laser treatment, by treating one side of the body or half scar using the SP and the other side using MoveoPL. Improvements according to a grading score system, side effects, and patient satisfaction were recorded. About 63 patients were enrolled. An overall improvement of benign hyperpigmentations and pigmented scars was recorded, with a grading score (±SD) of 2.8 ± 0.8 for SP and 3.6 ± 0.5 for MoveoPL (range, 0-4). SP emission showed best results in skin types I-II whereas MotusPL obtained successfully results in all the phototypes analyzed (types I-IV). Patients preferred MoveoPL as it was associated with fewer side effects. Both standard SP and MoveoPL emission are effective and safe. MoveoPL showed a higher efficacy and safety profile for the treatment of hyperpigmentations.

Cryopeeling versus trichloroacetic acid peeling in the treatment of solar lentigines: Effect on epidermal Langerhans cells.

Trichloroacetic acid (TCA) peeling may be effective in solar lentigines, but with concerns regarding potential tumorigenesis. Cryopeeling would be better with improving the whole sun-damaged skin. We aimed to compare the efficacy and safety of cryopeeling and TCA 35% peeling for treatment of solar lentigines and assess their influence on the number of epidermal Langerhans cells (LC). Twenty-five patients were treated with TCA 35% and cryopeeling on the right and left hands, respectively. Two sessions were done 3 weeks apart. Evaluations were scheduled at weeks 0, 3, and 6. Skin biopsies, taken before and after treatment, were evaluated histologically and immunohistochemically for the number of CD1a + epidermal LCs. Lentigines decreased after cryopeeling from the first session (p < .001), but after the second session with TCA peeling (p = .004). Cryopeeling produced significant lightening, compared with TCA (p = .015). Blistering, hyper/hypopigmentation were reported with cryopeeling, whereas only hyperpigmentation was noted after TCA peeling. The LCs remained at about the pretreatment number after cryopeeling (p = .058), though they decreased after TCA (p = .002). Cryopeeling provided faster and superior improvement of lentigines compared with TCA peeling. Furthermore, TCA seems to suppress LCs raising the concern for carcinogenic potential.

Prospective study of removing solar lentigines in Asians using a novel dual-wavelength and dual-pulse width picosecond laser.

OBJECTIVES: Quality-switched (QS) lasers are known to be an effective treatment for removing solar lentigines, however, high incidence of post-inflammatory hyperpigmentation (PIH) is a concern in darker skin types. The objective of this study was to evaluate the efficacy and safety of a dual-wavelength and dual-pulse width picosecond Nd:YAG laser for removing solar lentigines in Asians. METHODS: This was a prospective, IRB-approved study. Twenty cases with solar lentigines on the face were enrolled for treatment and evaluated at 1- and 3-month after the final treatment. Results were assessed by blinded evaluators using a 5-grade percentage improvement scale and Melanin index (MI) measured by a reflectance spectrophotometer. A patient self-assessment questionnaire was also administered using a 5-grade improvement scale. Additional treatment was performed if the improvement was less than 75% or the lentigo partially remained after 4 weeks. Histological evaluation was performed to compare the differences between the current picosecond laser and a QS Nd:YAG laser 532-nm using light and electron microscopy. RESULTS: Forty-three lesions in 20 females, skin type III or IV, age 53.7 ± 9.75 were treated and evaluated. The laser setting was: 532-nm, 750 picoseconds, average fluence of 0.35 ± 0.06 J/cm [2] using a spot size of 3 or 4 mm. Forty lesions (93.02%) achieved over 75% clearance with a single treatment and the other three lesions (6.98%) needed two treatments. PIH occurred only in 4.65% of lesions. The average score of the blinded evaluators' assessment was 4.77 and 4.58 on a 5-grade percentage improvement scale. The patients' self-assessment rating was 4.76 and 4.67 on a 5-grade scale at 1- and 3-month follow-up, respectively. The improvement rate of relative MI (MI in the lesion minus that of the normal area) was 77.60 ± 36.27% and 76.93 ± 20.95% at 1-and 3-month follow-up. Histology showed vacuolar formation by both lasers in the epidermis that were different sizes between lasers. Electron microscopy showed destruction of melanosomes with surrounding tissue damage with the QS laser and without particular damage with the picosecond laser. CONCLUSIONS: To the best of our knowledge, this is the first study using a picosecond Nd:YAG laser 532-nm for removing solar lentigines in darker skin types that includes histological evaluation. Although there are many options to treat solar lentigines, our results suggest that picosecond laser with preferable endpoint determination can be a safer and more effective treatment over conventional treatments in Asian patients. Lasers Surg. Med. 50:851-858, 2018. © 2018 Wiley Periodicals, Inc.

Genetic 3'UTR variation is associated with human pigmentation characteristics and sensitivity to sunlight.

Sunlight exposure induces signalling pathways leading to the activation of melanin synthesis and tanning response. MicroRNAs (miRNAs) can regulate the expression of genes involved in pigmentation pathways by binding to the complementary sequence in their 3'untranslated regions (3'UTRs). Therefore, 3'UTR SNPs are predicted to modify the ability of miRNAs to target genes, resulting in differential gene expression. In this study, we investigated the role in pigmentation and sun-sensitivity traits, as well as in melanoma susceptibility, of 38 different 3'UTR SNPs from 38 pigmentation-related genes. A total of 869 individuals of Spanish origin (526 melanoma cases and 343 controls) were analysed. The association of genotypic data with pigmentation traits was analysed via logistic regression. Web-based tools for predicting the effect of genetic variants in microRNA-binding sites in 3'UTR gene regions were also used. Seven 3'UTR SNPs showed a potential implication in melanoma risk phenotypes. This association is especially noticeable for two of them, rs2325813 in the MLPH gene and rs752107 in the WNT3A gene. These two SNPs were predicted to disrupt a miRNA-binding site and to impact on miRNA-mRNA interaction. To our knowledge, this is the first time that these two 3'UTR SNPs have been associated with sun-sensitivity traits. We state the potential implication of these SNPs in human pigmentation and sensitivity to sunlight, possibly as a result of changes in the level of gene expression through the disruption of putative miRNA-binding sites.

Integrated Bioinformatics Analysis Reveals Diagnostic Biomarkers and Immune Cell Infiltration Characteristics of Solar Lentigines.

Background: Solar lentigines (SLs), serving as a prevalent characteristic of skin photoaging, present as cutaneous aberrant pigmentation. However, the underlying pathogenesis remains unclear and there is a dearth of reliable diagnostic biomarkers. Objective: The aim of this study was to identify diagnostic biomarkers for SLs and reveal its immunological features. Methods: In this study, gene expression profiling datasets (GSE192564 and GSE192565) of SLs were obtained from the GEO database. The GSE192564 was used as the training group for screening of differentially expressed genes (DEGs) and subsequent depth analysis. Gene set enrichment analysis (GSEA) was employed to explore the biological states associated with SLs. The weighted gene co-expression network analysis (WGCNA) was employed to identify the significant modules and hub genes. Then, the feature genes were further screened by the overlapping of hub genes and up-regulated differential genes. Subsequently, an artificial neural network was constructed for identifying SLs samples. The GSE192565 was used as the test group for validation of feature genes expression level and the model's classification performance. Furthermore, we conducted immune cell infiltration analysis to reveal the immune infiltration landscape of SLs. Results: The 9 feature genes were identified as diagnostic biomarkers for SLs in this study. And an artificial neural network based on diagnostic biomarkers was successfully constructed for identification of SLs. GSEA highlighted potential role of immune system in pathogenesis of SLs. SLs samples had a higher proportion of several immune cells, including activated CD8 T cell, dendritic cell, myeloid-derived suppressor cell and so on. And diagnostic biomarkers exhibited a strong relationship with the infiltration of most immune cells. Conclusion: Our study identified diagnostic biomarkers for SLs and explored its immunological features, enhancing the comprehension of its pathogenesis.

Targeting SDF-1 as an efficient strategy to resolve skin hyperpigmentation issues with Himanthalia elongata extract.

BACKGROUND: During aging, human skin is facing hyperpigmentation disorders: senile lentigo (chronobiologic aging) leads to loss of melanogenesis' control while solar lentigo (UV exposure) promotes an increase of oxidized proteins, melanogenesis, and lipofuscin. AIMS: Stromal-cell-derived-factor-1 (SDF-1) was identified as key regulator of hyperpigmentation and its expression is reduced in senescent fibroblasts, highlighting this protein as new target for skin hyperpigmentation. MATERIALS: We developed two skin explant models mimicking of senile and solar lentigo, based on H2 O2 systemic treatment and UV irradiation, respectively. We evaluated Himanthalia elongata extract (HEX) on these models after 5 days of treatment and analyzed SDF-1 expression and skin pigmentation. For solar lentigo, we also analyzed oxidized proteins and lipofuscin accumulation. Finally, we evaluated HEX in vivo on nearly 100 multi ethnicities' volunteers. RESULTS: SDF-1 expression decreased in senile lentigo model, associated with hyperpigmentation. HEX application restored SDF-1 expression, leading to skin pigmentation decrease. For solar lentigo, we showed an impact of UVs on SDF-1 expression linked to hyperpigmentation, while the application of HEX restored SDF-1 expression and reduced skin pigmentation. On same model, HEX reduced oxidized proteins quantity and lipofuscin which increased after UV exposure. Clinically, HEX reduced dark spot pigmentation on Caucasian volunteers' hands and on Asian and African volunteers' face after 28 days. DISCUSSION: We have developed ex vivo models mimetic of senile and solar lentigo and showed for a very first time that SDF-1 can be also a key regulator for UV-induced hyperpigmentation. CONCLUSION: Our ex vivo and clinical studies highlighted the power of HEX with strong reduction of dark spots regardless of volunteers' ethnicities.

Efficacy of topical vitamin C in melasma and photoaging: A systematic review.

BACKGROUND: Vitamin C is a micronutrient present in high concentrations in normal skin and a highly prescribed cosmeceutical, well known for protecting against ultraviolet-induced pigmentation and regulating collagen production. However, there is a lack of studies evaluating the efficacy of topical vitamin C in photoaging and melasma, with this systematic review being the first to assess the existing evidence. AIM: This systematic review aims to assess whether topical vitamin C could be effective in reversing photoaging signs and treating melasma. METHODS: Prospective, randomized controlled trials assessing protocols with topically applied vitamin C in patients with melasma or photodamage were searched in Medline, CENTRAL, and Scopus databases until the 12th of May 2022. Risk of bias was conducted in accordance with Cochrane Collaboration's tool for assessing the risk of bias in randomized trials, using RevMan 5.0. RESULTS: Seven publications were included, with 139 volunteers in total. Studies that evaluated the topography of skin indicated that the treated skin appeared smoother and less wrinkled, which was supported by biopsies data. On objective assessments of pigmentation, there was a significant lightening of the skin treated. Hydration improved equally in the vitamin C and placebo-treated sites. CONCLUSIONS: This study revealed that vitamin C is effective in treating uneven, wrinkled skin and has depigmenting properties, but long-term use may be needed to achieve noticeable changes. Q-switched Nd:YAG laser-associated protocols appear beneficial in enhancing vitamin C effects. Topical vitamin C may be a suitable alternative for melasma and photoaging, but more studies are needed to confirm these results and assess the ideal vitamin C concentration.

12-Week, Single-Center Study of a Targeted Pigment-Correcting Dark Spot Treatment for Post-Inflammatory Hyperpigmentation and Solar Lentigines.

Purpose: Post-inflammatory hyperpigmentation (PIH) and solar lentigines are dark spots of skin from excessive melanin production due to injury or UV exposure. This 12-week single-center study assessed the efficacy and tolerability of a novel targeted pigment-correcting spot treatment gel suspension cream (Dark Spot Treatment) for improving mild-to-moderate PIH or solar lentigines. Patients and Methods: Female participants (N = 41) aged 25-65 with mild-to-moderate facial dark spots applied Dark Spot Treatment daily for 12 weeks. Investigators assessed overall hyperpigmentation, skin tone evenness, and dark spot intensity, contrast, and size at Weeks 2, 4, 8, and 12. Participant self-assessments occurred at Weeks 1, 2, 4, 8, and 12. Tolerability was assessed by clinical grading and participant reporting. Results: Dark Spot Treatment improved overall hyperpigmentation, skin tone evenness, and dark spot intensity and contrast at Weeks 2 through 12, and dark spot size at Weeks 4 through 12 (all p < 0.001 compared to baseline). Participant self-assessments showed high overall satisfaction. Dark Spot Treatment was well tolerated. Conclusion: The novel pigment-correcting Dark Spot Treatment significantly improved the appearance of PIH and solar lentigines, had high participant satisfaction, and was well tolerated.

The clinical and electron microscopic evaluation of the impact of pulsed dye laser techniques on solar lentigines (randomized clinical trial).

BACKGROUND: Solar lentigines are skin lesions manifested by benign dark pigmentation causing a cosmetic problem in many patients. Several treatment modalities used for the management of solar lentigines. Side effects and rates of recurrence may be associated with them. OBJECTIVE: Treating solar lentigines with two different techniques of pulsed dye laser (PDL) and evaluation of the results both clinically and via the examination of ultrastructural changes by electron microscopy. PATIENTS AND METHODS: This study was conducted on 22 subjects with solar lentigines and having Fitzpatrick III-IV skin types, was managed by the use of PDL after enrolling them into two groups. Group I (one stacked PDL was used) and Group II (treated by stacked PDL in two sessions, 1 month apart). At baseline and 6 months after treatment, two punch biopsies with a diameter of 2 mm were taken from all patients. All taken biopsies were prepared for light and electron microscopic examinations. RESULTS: Both PDL techniques induced significant better clinical and histological outcomes. No one demonstrated any postoperative complications such as post-inflammatory hyperpigmentation and scarring. CONCLUSIONS: The two techniques of PDL are efficient for solar lentigines treatment.

Ozonized glycerin (OG)-based cosmetic products lighten age spots on human facial skin.

BACKGROUND: Few cosmetic ingredients are shown to be able to safely remove or lighten facial dark spots once they have formed. OG has been reported to possess oxidation power and exhibit various biological activities such as antibacterial, antiviral, and wound healing promotion. AIMS: This study aimed to clarify the effects of OG on human skin, especially on age spots on the face. METHODS: OG formulations (80 and 800 ppm) were mixed with synthetic melanin in vitro for 4 weeks and then assessed for its ability to degrade the melanin. OG also investigated its effect on gene expression of keratinocyte differentiation markers in vitro to explore the cell maturation. In clinical study for the evaluation of effects of OG formulations on age spots on facial skin, 48 women were measured for the melanin content of them by a Mexameter at 4 and 8 weeks after daily twice application of OG formulations. Adverse events were monitored during the study. RESULTS: Both OG formulations showed direct melanin degradation in a time-dependent manner, with significant effects observed as early as 6 h. OG formulation at 800 ppm showed higher activity than OG formulation at 80 ppm, and the amount of melanin was decreased by about 40% on Day 14 of the mixing reaction. Differentiation marker studies using human keratinocytes showed that the gene expression of involucrin and serine palmitoyltransferase was upregulated by OG, which was almost equivalent concentration to OG formulation 80 ppm, suggesting that OGs can enhance turnover of the skin epidermis. In clinical study, OG formulations 80 and 800 ppm showed larger decreases in melanin contents at 8 weeks compared with those at 4 weeks and their mean values of △melanin index were -16.7 and -15.2, respectively. Statistically significant differences were detected against respective controls. Number of subjects with a decrease in melanin index from baseline to 4 or 8 weeks increased in both OG formulations 80 and 800 ppm, especially prominent at 8 weeks. There were no adverse events related to treatments of OG 80 and 800 ppm during the study. CONCLUSION: The result indicated that applications of OG formulations are safe and effective in lightening age spots on the facial skin.

Blue Laser (450 nm) Treatment of Solar Lentigines.

This study tested a blue light source for the treatment of solar lentigines. A total of 14 patients with solar lentigines were treated with radiation from a novel, high-power 450 nm blue laser that was created for this project. The group contained eight patients with solar lentigines on the face, two patients with the lesions on the dorsal of the hands, and four patients with the lesions on the trunk and forearms. The best results (complete recovery) have been achieved for the lesions on the face and dorsal of the hands. The treatment of lesions on the trunk and forearms was not fully satisfying due to the occurrence of slight scarring. This study shows that, in some cases, the use of a blue laser may be an alternative to the use of longer wavelength sources.

Lifetime UVR Dose and Skin Cancer Risk, Determined by Their Common Relation to Solar Lentigines.

BACKGROUND/AIM: Ultraviolet radiation (UVR) causes solar lentigines (SL) and skin cancer (SC) in humans. The association between measured lifetime UVR dose and SC has not been investigated. This study investigated this relation through their common relationship to SL. MATERIALS AND METHODS: First we investigated the association between lifetime UVR dose and SL for 16,897 days in 38 healthy participants, and secondly, the relation between SL and SC was investigated in 2,898 participants, including 149 with SC. By combining both studies, SC risk related to lifetime UVR dose and skin phototype was estimated. RESULTS: A positive association was found between SL and lifetime UVR dose (p=0.060). Skin phototype (p=0.001) and SL (p<0.001) were associated with SC. Combined SC risk increased 1.23 by doubling the average lifetime UVR dose and was 34.9 times higher for those with very fair skin compared to dark Mediterranean skin. CONCLUSION: The estimate of SC risk shows that skin phototype is of greater relative importance than lifetime UVR dose.

Retrospective photographic review of nontattoo indications treated by picosecond laser.

BACKGROUND: Picosecond (PS) lasers were approved by the US FDA in 2012 after being shown to remove tattoos with more success and fewer treatments compared with traditional methods. PS lasers were shown to be versatile, indicated for the treatment of lentigines, café-au-lait macules (CALMs), and acne scars and skin rejuvenation. OBJECTIVE: We report our experience treating our patients for different indications using a PS laser. METHODS: We performed a retrospective chart and photographic review of all patients seen between 2016 and 2018 that were treated in our centers with a PS laser for nontattoo indications. Clinical outcomes were evaluated using side-by-side comparisons of the clinical photographs by two blinded, independent physicians using a visual analog scale consisting of six levels of treatment response. RESULTS: A total of 233 patients were studied. Most sought treatment for solar lentigo (27%) and skin rejuvenation (14%). Epidermal nevi exhibited the greatest improvement with treatment, while acne scarring demonstrated the least. Only 24% of patients experienced noteworthy, transient adverse effects. CONCLUSION: Picosecond lasers were efficacious and safe for a variety of indications. They were effective in treating epidermal nevi and pigmented lesions, such as Lentigines and CALMs.

Organ transplant recipients express enhanced skin autofluorescence and pigmentation at skin cancer sites.

BACKGROUND: Skin autofluorescence and pigmentation can estimate photodamage and sun exposure. These techniques may quantify differences in actinic damage between high-risk organ transplant recipients (OTRs) and immunocompetent patients. METHODS: Age and gender-matched OTRs (n = 15) and immunocompetent controls (n = 15) with a new keratinocyte carcinoma (KC) were included. We measured skin autofluorescence (370 nm excitation, F370) and skin pigmentation at five standardized body sites; and determined black light-evaluated solar lentigines on the shoulders and photosensitivity to UVA and simulated solar radiation (SSR) as minimal erythema doses (MED). RESULTS: F370 autofluorescence values were enhanced at KC site versus other body sites in OTRs (2208 vs. 1458-1898 AU, p < 0.05). Compared with non-OTRs, OTRs expressed higher F370 autofluorescence at KC site (2208 vs. 1385 arbitrary units AU, p = 0.01) and the shoulder (1898 vs. 1525, p = 0.05). Likewise, OTRs had increased skin pigmentation (25.0 vs. 20.8 pigment%, p = 0.05) and solar lentigines (3.5 vs. 3.0, p = 0.048) on the shoulders. MED tests showed increased UVA photosensitivity in OTRs (2.4 vs. 1.7 times higher than expected, p = 0.03), whereas SSR photosensitivity was similar. CONCLUSION: Quantified F370 autofluorescence, skin pigmentation, and density of solar lentigines could serve to assess photodamage in OTR. Increased UVA photosensitivity may account for higher skin photodamage.

Treatment of solar lentigines using a combination of picosecond laser and biophotonic treatment.

Treating solar lentigines using picosecond-switched lasers that selectively remove the excess pigment was combined with Kleresca® biophotonic treatment. This therapy uses fluorescent light energy to stimulate healing by increasing collagen production and reducing inflammation. Combining these therapies successfully removed solar lentigines and achieved normalized and rejuvenated treated skin.

Efficacy of Trifecting® Night Cream, a Novel Triple acting Skin Brightening Product: A Double-blind, Placebo-controlled Clinical Study.

Background: Melasma is a common, persistent disorder of hyperpigmented facial skin predominantly attributed to ultraviolet light exposure, hormonal influences, and genetic predisposition. Objectives: This double-blind, placebo-controlled, randomized clinical trial was conducted to assess the efficacy and tolerance of a multimodality night cream when used over a course of 24 weeks followed by a four-week regression in female subjects with moderate to severe melasma, presence of solar lentigines, and periocular lines and wrinkles. Methods: Subjects were randomized into one of two groups: Cell 1 received Trifecting® Night Cream (Envy Medical, Long Beach, California) 1.0 and Cell 2 did not. All subjects were supplied with a two-product regimen comprising a cleanser and sunscreen to use during the trial. Clinical grading, tolerability assessments, and Chroma Meter measurements (Konica Minolta, Tokyo, Japan) were performed at baseline and at Weeks 8, 16, 24, and 28 (regression). Standardized digital photographs were taken and self-assessment questionnaires were completed. Results: Twenty-five subjects completed the 28-week study, with 14 subjects in Cell 1 and 11 subjects in Cell 2. Subjects in both groups showed improvements in facial conditions. Cell 1 outperformed Cell 2 in improving fine lines, solar lentigines, and melasma conditions. These improvements were sustained during regression period. Conclusions: Trifecting® Night Cream 1.0, is effective for the treatment of moderate to severe melasma, solar lentigines, and periocular lines and wrinkles over 24 weeks of usage, with its benefits sustained for at least four weeks after treatment.

Effects of topical application of B-Resorcinol and Glycyrrhetinic acid monotherapy and in combination with fractional CO2 laser treatment for benign hand hyperpigmentation treatment.

BACKGROUND: Hand solar lentigines are frequent benign lesions of elderly population, requiring longtime treatments with topical agents or laser to lighten. AIMS: The aim of this study was to evaluate and compare the efficacy of CO2 fractional laser photothermolysis followed by topical application of B-Resorcinol and Glycyrrhetinic acid vs. only topical B-Resorcinol and Glycyrrhetinic acid application for hand solar lentigines treatment. METHODS: Hand solar lentigines of eleven volunteers were divided into two groups: Group A spots received CO2 fractional laser photothermolysis followed by 4 weeks topical application of B-Resorcinol and Glycyrrhetinic acid, and Group B spots received only 4 weeks topical treatments. All hands were photographed, and hand solar lentigines scanned with dermatoscope at the beginning of the study (T0 ), 1 month after laser treatment (T1 ), and at the end of the study (T2 ) to document spots dimensions and color. A blinded dermatologist evaluated dermoscopic T0 and T2 images. The considered variables were assessed for significance by the nonparametric Mann-Whitney U-test. RESULTS: In all volunteers, investigators and blinded dermatologist's evaluation hand solar lentigines features improved, with no statistical differences in the two groups. CONCLUSION: Topical application of B-Resorcinol and Glycyrrhetinic acid is effective to lighten hand solar lentigines after 4 weeks of treatment, with or without a previous fractional laser photothermolysis.

A genome-wide association study in Caucasian women suggests the involvement of HLA genes in the severity of facial solar lentigines.

Solar lentigines are a common feature of sun-induced skin ageing. Little is known, however, about the genetic factors contributing to their development. In this genome-wide association study, we aimed to identify genetic loci associated with solar lentigines on the face in 502 middle-aged French women. Nine SNPs, gathered in two independent blocks on chromosome 6, exhibited a false discovery rate below 25% when looking for associations with the facial lentigine score. The first block, in the 6p22 region, corresponded to intergenic SNPs and also exhibited a significant association with forehead lentigines (P = 1.37 × 10(-8) ). The second block, within the 6p21 HLA region, was associated with decreased HLA-C expression according to several eQTL databases. Interestingly, these SNPs were also in high linkage disequilibrium with the HLA-C*0701 allele (r(2)  = 0.95). We replicated an association recently found by GWAS in the IRF4 gene. Finally, a complementary study on 44 selected candidate SNPs revealed novel associations in the MITF gene. Overall, our results point to several mechanisms involved in the severity of facial lentigines, including HLA/immunity and the melanogenesis pathway.